Privatization in healthcare – management of extramural nursing and Tele-Care

The New Brunswick government is following through on its plan to hand management of extramural and Tele-Care services over to the private sector, prompting both criticism and accolades from health-care providers and labour groups.

Medavie Health Services New Brunswick, which already runs the paramedic service Ambulance New Brunswick, will take over the home health-care program and 811 health advice line effective Jan. 1, Health Minister Victor Boudreau announced in Moncton on September 1st.

The estimated cost of the first year of the 10-year contract, which was awarded without a tendering process, is $4.4 million.

The aim of the “primary health-care integration initiative” is better co-ordination and collaboration among health-care providers to enable people to stay in their homes as long as possible, get more help navigating the health-care system, and to experience greater continuity of care, he said.

Boudreau said this doesn’t mean a privatization of any health care, because nursing and Tele-Care will continue to be free for patients and paid for by the province.

Nurses and other employees remain public-sector workers under the contract with Medavie, said Boudreau. Their salaries, benefits, pension plans and work agreements remain unchanged. Only senior managers will become Medavie employees.

There won’t be any job losses, said Boudreau, who was accompanied by former New Brunswick Progressive Conservative premier Bernard Lord, the CEO of Medavie Inc., based in Moncton.

Performance-based contract

“This is not a cost-cutting exercise,” the minister said.

The move is expected to cost more initially, but savings are expected over the long term, as heath care needs grow.

“With our province’s aging population, we know we need to strengthen the community-based, primary health-care system,” said Boudreau.

“We need to ensure that New Brunswickers receive the appropriate care, at the appropriate time and place, by the appropriate provider.”

The contract is incentive-based to minimize the risk to the province, said Lord.

Payment to Medavie is contingent upon certain performance targets being met, such as more patients being served by extramural, decreased emergency room visits by extramural patients, and decreased wait times between referral to extramural and service delivery.

“If we don’t meet the standards, we don’t get paid,” he said. “The employees still get paid, the nurses, all the health professionals, they still get paid, but Medavie does not get paid.”

“Therefore it puts the province and the government in a position to enforce those standards.”

‘Deeply disappointed’

Gilles Lanteigne, Vitalite Health Network president and CEO

Vitalite Health Network president and CEO Gilles Lanteigne called the announcement a sad day for New Brunswickers. (CBC)

The plan was previously unveiled in February 2016 during the release of the Department of Health’s budget to the legislative estimates committee.

At the time, Boudreau said that by grouping the services together, Medavie may be able to better help the five per cent of the population that use the services most often.

The Vitalité Health Network’s board of directors and leadership team are “deeply disappointed” with the government’s decision to proceed with privatizing the management of extramural, board chair Michelyne Paulin said in a statement issued Friday morning, before the official announcement.

It goes against the board’s recommendation to the Department of Health in June 2016 to maintain the service under the authority of Vitalité and contravenes the Regional Health Authorities Act, she said.

“According to this legislation, the health authorities are vested with the delivery and administration of health care [in] their territory. As a board of directors, we are puzzled,” said Paulin.

The board is worried about the “ongoing erosion of its authority,” she added.

Vitalité president and CEO Gilles Lanteigne said privatization of the management of home care is “somewhat withdrawing a powerful tool” from the regional health authority to achieve its mission “to excel in improving people’s health.”

“Splitting the provincial health system up into several components will make it increasingly difficult for us to achieve expected results, namely in terms of quality, continuity of care, effectiveness and efficiency,” he said.

CUPE is also opposed to the deal, Simon Ouellette, spokesman for the Maritimes regional office, said in an email to CBC News.

“Consolidation of operations is not a bad idea, but it should be run through the public,” said Ouellette.

Medavie Health Services, which is based in Dartmouth, N.S., “is becoming quite the big business,” he said. “It is testing operations and programs on the backs of New Brunswickers and then setting up more operations elsewhere when they will have worked out the kinks here.”

The province’s extramural service is “a leading model” for alternative health care delivery in Canada, said Ouellette.

“Rather than turning it over to private management, it should remain within the public sphere and be expanded to increase efficiency within our present system.”

CUPE National Representative Ralph McBride also objected strongly to the decision.

“The biggest item for us is that we’re taking the management cycle outside of health care and putting it into a private corporation’s hands. We’ve got concerns about private entities having control over public health care,” he said.

“Honestly, I think there’s a bigger picture in play here. I think there’s a move to take and offload as much responsibility out of the government into private entities which I think is bad for the public because we lose control of our public interests. The accountability is gone.”

**(Article Source : excerpts from CBC News Article by Bobbi-Jean MacKinnon, posted on Sep 01, 2017 & excerpt from Times & Transcript article by Tom Bateman, September 1st, 2017)**

Labour Day 2017

This September 4, Labour Day events will take place across our province and our country to celebrate all that workers have achieved – and for good reason.

Since the late 1800s, Labour Day has been a labour tradition in New Brunswick: it’s a day of celebration of the power of working people coming together to demand what’s right. Decent wages, solid benefits and retirement with dignity. Social and economic justice and responsible stewardship of our resources and our environment. No benefits that workers enjoy was ever “given” to us—not the weekend, not sick leave, not overtime, not even the 8-hour day—working people united and fought for them.

Good union jobs continue to be the backbone of our working class, and the stable incomes they provide support strong families and vibrant communities. Unfortunately, the good standard of living that many Canadian families enjoy is being threatened by the rise of precarious work and privatization. Too many workers are stuck in precarious jobs that offer low wages, unpredictable hours, no pension, no benefits and no union. Privatization significantly increases the power and influence of financial elites at the expense of the collective power of citizens. This trend creates economic insecurity and strains our public resources.

These two trends must be reversed. We can bring services back in house and we can update legislation to bring back fairness to labour laws. As a progressive force, we must continue to use our voice to address social injustices, inequity, and job discrimination faced by marginalized communities.

This Labour Day we’ll be celebrating all the past achievements of our fellow workers. We will also be recommitting ourselves to keep pushing for further rights to improve the lives of all New Brunswickers – unionized or not. September 4th is therefore a day for organizing and demonstrating the power of working people.

In one year, New Brunswickers will head to the ballot boxes for provincial elections.  Mobilizing the movement starts with encouraging friends, neighbours and co-workers to take active roles in the political process, either by running or supporting progressive candidates. Working people united create a positive force that cannot be denied.

On behalf of all 27,000 CUPE members across New Brunswick, Happy Labour Day to all!

In solidarity,

Daniel Légère
President, CUPE New Brunswick

NB Day: Premier Recognizes Labour Movement’s Contribution

Edmundston – CUPE members were pleased to hear Premier Gallant recognize the importance of the labour movement in his New Brunswick Day speech in Edmundston. Gallant emphasized the valuable contribution of public sector workers to the province.

“It was certainly uplifting to hear Gallant thanking NB workers and mention the labour movement’s dedication to make New Brunswick a better place,” said Daniel Légère, CUPE NB President. “The event’s organizers did an excellent job good job, union members and citizens were well received, the event was a success,” he added.

In his speech, Premier Gallant added a special thank you to the front-line workers delivering services at the Edmundston regional hospital.

However, Gallant has yet to change his position on the Sodexo deal, since his own Health minister declared in late June that he was still going forward with the contracting-out plan, which will put over 280 health workers out of a job.

“The same front-line workers who were thanked on NB day are hoping the Premier’s acts be in coherence with his words: he must stop the Sodexo deal,” said Légère.

Grand Fall: Union dissatisfied with slow negotiations

Local 886 of the Canadian Union of public employees (CUPE) representing municipal employees of the Town of Grand Falls is dissatisfied with the slowness of the negotiations with the employer.

The Union is frustrated by the employer that insists on attacking the principle of seniority, basic element in any collective agreement. Notably, the employer wishes to exclude new workers hired on temporary contract of the collective agreement.

“Our demands are very reasonable and represent the current situations in the workplace. “I don’t understand why the city won’t move ‘, says Aldéo Cyr, president of the local and certified Manager of the water treatment.

The city representative said the Union that he wants to address not only by seniority, but wants to have full freedom to lay off municipal employees and have a free use the outsourcing of services.

“We had much better relations with the city before, but now, they want to even talk of contracting out and attack to seniority. These attacks come out of nowhere,” says Aldéo Cyr.

In the face of intransigence on the part of the municipality, the Union made a request of an Ombudsman – an independent third party – in order to unblock the negotiating process.

“We hope to settle this summer – and I hope that the city will not coach until conciliation process”, said Gérald Leblanc, Union of CUPE representative.

Local 886 CUPE represents 18 employees to the town of Grand Falls and operates including recreation, roads, public works and water treatment areas.

ANBL Should Manage Recreational Cannabis

Fredericton – CUPE Local 963, the union representing NB Liquor workers, is encouraged by the conclusions of the interim report released this week by a working group on cannabis legalization.

This government led report outlined the necessity for a public model for the legalization of recreational cannabis.

“I am encouraged, because the working group has recognized explicitly that ANBL and Local 963 workers have ‘extensive experience in retailing a controlled substance and has systems in place to support the retail environment for recreational cannabis’”, said Jaimie Agnew, President of CUPE Local 963.

As government is aiming for a completely public model, the government has, however, yet to guarantee it will go with ANBL rather than create a new Crown Corporation altogether.

“We hope they do this through our existing Crown Corporation. Our members have the skills, the professionalism to do the job right. Public control is really key to the success of any safety plan,” said Daniel Légère, president of CUPE NB.

“We will participate in the public consultations during the summer, and we will certainly repeat the message that ANBL is the least costly way to ensure safety, retail compliance and enforcement,” concluded Légère.

A Community Comes Together To Protect Seniority

The municipal workers of CUPE Local 1188, operating in the small university town of Sackville, New Brunswick, are still in awe by the level of community support they received in their recent victory to protect seniority rights.

At the bargaining table, Council and the Town’s new Chief Administrative Officer (CAO) had remained steadfast: they demanded the union accept a contract which removed seniority as a consideration when a temporary, part-time or casual employee applied for a full-time position.

“The last labour conflict our local had was about thirty-five years ago, in the 1980s. The Council and CAO must have thought we were weak, ready to accept anything,” said Marcos Salib, CUPE’s servicing representative for the Local. “They wanted to use fear of a lockout/strike situation and our feeling of isolation to their advantage,” he added.

The disconcerting attack had initially shocked and reduced morale amongst members – a few were contemplating signing a two-tier contract. However, the “Seniority Matters” campaign and member education grew internal confidence: members’ fear developed into anger, then indignation turned into resolve.

CUPE NB along with the Regional Action Committees engaged other CUPE locals in the area and gradually reached beyond immediate supporters. Firefighters, bakery workers, nurses, retail workers and other Regional Labour Council partners mobilized in Sackville. Ordinary citizens started to ask more and more questions to the Towns’ councilors as awareness and support grew.

Within six months, from December 2016 to May 2017, the Local had escalated pressure through all the hoops of a campaign: lobbying, leaflets, petitions, strike education, radio ads, lawn signs, public rallies, town hall meetings & more.

“Council thought they could drive a wedge between members as they sweetened the deal to exclude the current workers from the seniority attack,” said Pam Hicks, Secretary of Local 1188.

In the end, the Council withdrew its ultimatum and has ratified a six-year contract with the Union. The deal provides for improved clothing and tool allowances, contains wage increases, wage adjustments for precarious workers – and most importantly – maintains all seniority rights.

“Sackville workers leave us with a great example of how we can successfully apply CUPE’s National Executive Board Bargaining Policy on fighting concessions and two-tier contract provisions to motivate and mobilize the workers,” said Daniel Légère, CUPE NB President. “Because of the new bargaining policy, there now is heightened awareness of the need to bring in the Division early in the process,” he added.

“Local 1188 members understand that they are part of a big movement. Being part of a union comes with many benefits, but also many responsibilities towards our fellow workers – including future workers. Together we build on past victories and make gains for those who will come after us,” concluded Légère.

Seniority matters! Fairness for Sackville municipal employees

Seniority allows for positions to be filled by the most senior worker qualified to obtain a position. It does not stop the Employer from choosing who they want as employees.

The town of Sackville wants to remove this longstanding clause to loyal part-time and temporary future employees hired by them.

Unions maintain fairness, equality and equal opportunity for all members after hiring!

Privatization in Healthcare: Expect Superbugs and Reheated Food

FREDERICTON: Both Vitalité and Horizon Health Networks are about to sign a 10-year deal to privatize management and operation of hospital food service, environmental services and patient transportation.

“We were informed that 280 full-time equivalent positions will be affected in the decision to sell off publicly run services to Sodexo, a French multinational corporation,” said Norma Robinson, President of New Brunswick Council of Hospitals Unions, CUPE Local 1252.

CUPE 1252 is very concerned by Sodexo’s grim track record: in other provinces and in the USA, they have been highly criticized, sued for overcharging governments and even kicked out of universities, jails, schools, and other institutions where they operated.

“It’s outrageous because we are already running a barebones operation. To save money and turn a profit, this company will inevitably cut corners. This will mean more hospital-borne infections and “superbugs”.  This government is putting sick people, seniors and our most vulnerable citizens’ health at risk,” said Robinson.

Less healthcare cleaning and infection control staff frequently results in more cases of Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), C. difficile and other infections caused by bacteria and viruses encountered in healthcare facilities.

In past meetings with the previous Health Minister, CUPE 1252 had been reassured that no privatization of these services would happen – because there were no solid guarantees to find savings without loss in quality and services.

“The health of patients and workers should matter: by keeping these services in-house, we can avoid costly and dangerous problems,” said Robinson.

“Despite past cuts, the Union did its best to make sure hospitals were meeting their cleanliness targets. Front-line workers and their supervisors were meeting on a regular basis to raise cleanliness standards in facilities,” said Robinson.

CUPE 1252 is also concerned that more frozen food systems will be implemented: “Is this the food New Brunswickers deserve when they are sick and dying in a hospital bed?” asked Robinson.